Individual
KEVIN CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3250 W LOWER BUCKEYE RD, PHOENIX, AZ 85009-6729
(602) 579-3846
Mailing address
201 S 4TH AVE, PHOENIX, AZ 85003-2138
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6943
AZ
Other
Enumeration date
10/26/2017
Last updated
04/27/2020
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